肿瘤病人出院期间深静脉导管堵塞原因分析及处理

Causes and treatment of blockage of deep venous catheter in cancer patients discharged from hospital

目的探讨肿瘤病人出院期间深静脉导管的堵塞情况，分析其堵塞原因、处理方法，并提出预防及注意事项等健康教育。方法回顾性分析2010年7月至2014年7月共9356例留置深静脉导管带管出院返院维护患者，其中73例发生不同程度的导管完全堵塞。结果50例经溶栓有效，导管再通，其中18例以肝素625U／mL通溶，32例肝素625U／mL＋尿激酶2000U／ml通溶。23例经上述处理无效，予拔管处理。结论导管堵塞绝大部分为血栓形成，因患者为出院期间，55％经询问均有引起深静脉堵塞的诱因，针对原因进行健康教育，预防导管堵塞措施相当重要。

Objective To explore the blockage of deep venous catheter in cancer patients discharged from hospital, analyze the blockage reasons and treatment methods, and put forward some health education such as prevention and precautions. Methods A total of 9 356 discharged patients with deep venous catheter and coming back to hospital from July, 2010 to July, 2014 were retrospectively analyzed; among which, 73 cases had different degrees of catheter blockage. Results 50 cases were effectively treated by thrombolytic therapy; among which, 18 were treated with 625 U/ml heparin and 32 cases 625 U/ml heparin ＋ 2 000 U/ml urokinase. 23 got no effect after the above treatments and were extubated. Conclusions Most catheter blockages are caused by thrombosis; because 55% patients had the causes of deep venous thrombosis, cause-targeted health education is important for the prevention of catheter blockage.